Google Searches About Suicide Spiked After '13 Reasons Why'

The Netflix series 13 Reasons Why has been controversial since its launch in March. The show was executive produced by Selena Gomez and based on the 2011 best-selling Jay Asher book by the same name. In it, teenager Hannah Baker leaves behind 13 cassette tapes—each dedicated to one of her peers—that explain why she chose to kill herself and how her peers harmed her. While some argue that the series helps raise awareness of the reality of suicide, others warn that it could trigger suicidal ideation (suicidal thoughts or impulses, in people who are already vulnerable).

Now, research suggests that the show had a significant impact on people's search histories.

According to a letter published in JAMA Internal Medicine on Monday, online searches related to suicide prevention and awareness increased after the show's premiere. Unfortunately, so did searches for terms related to the mechanisms of suicide. For example, the phrase "how to commit suicide" increased 26 percent above what the researchers say was normal for that time period. At the same time, searches for "suicide prevention" increased 23 percent and "suicide hotline number" increased 21 percent. The researchers also found that all suicide searches were 19 percent higher for the 19 days following the release of 13 Reasons Why, making up 900,000 to 1.5 million more searches than would have been expected at that time.

In an accompanying editorial, the writers point out that they can’t say for certain whether searches for terms like “how to kill yourself” were made from people who were curious or those who were actually contemplating suicide. “While it is likely that far more were due to the former, the producers of the series should have taken steps to mitigate the latter, as encouraged by suicide prevention specialists,” they write. They specifically point out that the show's producers could have paid greater attention to safe messaging guidelines for suicide prevention. Among other things, these guidelines suggest an emphasis on seeking help when covering the topic of suicide and providing information on how to do so, like calling the National Suicide Prevention Lifeline (1-800-273-TALK). The guidelines also strongly discourage showing pictures or detailed descriptions of how or where a person died by suicide; yet in the series, Hannah had an incredibly graphic suicide scene.

An increase in online searches related to suicide does not prove that the show actually sparked incidences of suicide.

“Ultimately, we are measuring search queries but cannot determine the true intention of the users or if these searches resulted in more suicides,” Mark Dredze, Ph.D., a professor at Johns Hopkins University and co-author of the study, tells SELF. However, he notes that he and his colleagues did a similar study after Charlie Sheen announced that he had HIV and confirmed that online searches correlated with actual HIV tests. That “suggests that there are real world effects to these searches,” he says.

Benjamin Althouse, Ph.D., a study co-author and research scientist at the Institute for Disease Modeling, agrees. “We do not know for sure if someone searching for ‘how to commit suicide’ is actually considering suicide themselves, is concerned for a friend or loved one, or is merely looking for information with non-serious interest,” he tells SELF.

Whether or not the show led to an increase in actual suicide attempts would be difficult to prove, but practicing mental health professionals may be able to offer insights into how the show impacted their own practices. “I saw a spike in teens talking and thinking about suicide,” licensed clinical psychologist John Mayer, Ph.D., author of Family Fit: Find Your Balance in Life, tells SELF, attributing it to the “copycat phenomenon,” in which a person mimics behaviors they see—in this case, a graphic portrayal of a teenage suicide and the practically vindictive effect it had on her peers. It's this revenge aspect that Dr. Mayer is particularly concerned about. The show implies that Hannah's actions served a purpose, which contradicts what mental health counselors try to teach people who are having thoughts of suicide. "When we work with suicidal individuals, therapists try to show that suicide will not have such a purpose except to devastate those that love you and/or have known you, even people not so close to you," he says.

In the show, Hannah is portrayed as a girl who was wronged, and her tapes are fuel to get revenge on those who wronged her. That depiction can have dangerous implications, suggesting that suicide is a viable option for those feeling helpless, a or way to feel vindicated after experiencing trauma. And teenagers may be especially vulnerable to these messages—especially when it comes to Hannah’s suicide scene, the graphic details of which can lead to a copycat effect. “Seeing a suicide depicted by a series protagonist is reckless and socially irresponsible to those watchers who—alone, depressed, and hopeless—may feel more willing to choose suicide as a way out having watched the series,” licensed clinical psychologist Alicia H. Clark, Psy.D., tells SELF. “Suicide will always be an option, but glamorizing it without educating about resources and showing it as a product of mental illness is reckless.” At-risk people who watch the show “need our help, not our indirect goading,” Dr. Clark says. There's a reason that graphic depictions of suicides are strongly discouraged in media: it can lead to a copycat effect. Not only does it send the message that this is a viable option, but it shows viewers how to do it.

Mental health experts are urging the show's producers to make adjustments in the current and future season to account for the significant impact it may have on viewers.

Netflix gave the show a TV-MA rating, meaning it’s intended for mature audiences only, and ran warnings before episodes that contained particularly graphic content. Netflix also launched the website 13ReasonsWhy.info the day of the show’s debut, which included information and links to suicide hotlines. Executive producers of the show also said in Beyond the Reasons, a video released by Netflix to accompany the series, that they consulted with several mental health professionals and doctors who helped shape the way the story covered suicide, sexual assault, and bullying. But experts argue that isn't enough.

“While 13 Reasons Why increased interest in suicide awareness, it also increased searches indicative of suicidal ideation,” study co-author Jon-Patrick Allem, Ph.D., a postdoctoral scholar research associate at the Keck School of Medicine of USC, tells SELF. He says removing the scenes that depict suicide and displaying hotline numbers at the start of each episode could help. Given that the series is on Netflix, it’s not too late to make those changes. “These suggestions could be retrofitted to season one and considered prior to the release of the second season,” he says.

Media and art can have a powerful impact on people, even in ways that are bad for their well-being, Dr. Althouse points out. “We as a public health community need to protect the health of individuals through rigorous science,” he says. “We urge suicide prevention information to be presented along current episodes of 13 Reasons Why as well as in the upcoming second season.”